RADIOLOGY/NUCLEAR MEDICINE
TECHNICAL MANUAL
Version 5.0
November 2013
Revised for:
· Patch RA*5.0113 Patient Specific Radiation Dose Aggregation
· RA*5.0*116 VistA Imaging Importer III Support
Department of Veterans Affairs
Health System Design and Development
Provider Systems
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REVISIONS
Revision History
Date / Page / Change /April 2002 / 6 / RA*5*27: Added the word Additional to the Clinical History subfile from File (#74)
TOC / RA*5*27: Updated Table of Contents
July 2002 / 52 / RA*5*25: Added Radiology HL7 Menu
51 / RA*5*25: A number of new protocols added
September 2002 / 11 / RA*5*31: Added new option - Credit Completed Exams for an Imaging Location
49 / RA*5*31: Added new option to Exported Menus
55 / RA*5*31: Added new option to [RA OVERALL]
56 / RA*5*31: Added new option to [RA OVERALL]
December 2002 / 57 / RA*5*35: Added new option to the User Utility Menu – Set preference for Long Display of Procedures [RA SET PREFERENCE LONG DISPLAY]
May 2003 / 7 / RA*5*34: Changed 9999 to 99999
8 / RA*5*34: Replaced example
9 / RA*5*34: Added data recovery text
10 / RA*5*37: Added RAD PERFORMANCE INDICATOR mail group.
52 / RA*5*37: Performance Indicator Menu Options added
January 2004 / 30 / RA*5*44: Added Schedule Perf. Indic. Summary for the fifteenth of the month.
May 2005 / 31 / RA*5.0*45: Reference to template compilation option has been updated to state that different sites may have different templates compiled.
33 / RA*5.0*45: Reference to non-existent HL7 specific appendices in the Technical Manual removed. HL7 specific documents have been created to: 1) describe interfaces with COTS applications 2) general HL7 message definition
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54 / RA*5.0*45: The Procedure File Listings menu has two new items; ‘RA CMAUDIT HISTORY’ & RA PROCMEDIA
65 / RA*5*45: Included the CPT MODIFIER (#81.3) file in the External Relations section.
68 / RA*5.0*45 changed the screen capture; the Version label erroneously displayed the version of the application as being 4.5, not version 5.
69 / RA*5.0*45: Removed all references to %INDEX, issues with using XINDEX regarding RAUTL8 have been addressed by the Kernel development team.
Glossary / RA*5.0*45: Updated definition of AMIS code. Removed references to contrast media.
August 2005 / Miscellaneous formatting corrections throughout
6 / RA*5*41: Text was deleted - On the Rad/Nuc Med patient file (#70), the activity log, clinical history, and exam status times are deleted. The entire request entry in the Rad/Nuc Med Orders file (#75.1) is deleted.
6 / RA*5*41: Text deletion. – Item 5 - Order data (ORDER DATA CUT-OFF). Purges the record (entire procedure request) from File (#75.1)
August 2005 / 7 / RA*5*41: The following text was deleted - The default number of days for the Order Data Cut-Off is 90 and, if changed, must be a whole number between 30 and 99999. The orders which will be purged include those whose last activity date is greater than the number of default days and whose order status is Discontinued, Hold, Complete, or Pending. Order purges can also be initiated by OE/RR.
7 / RA*5*41: Additional text description - This number should 0, as the option no longer allows purging of orders.
8 / RA*5*41: Text change and deletion - ^RAO - …but not data from ^RAO (order data) - …order data and changed 5 items to 4.
12 / RA*5*41: Deletion of prompt and response " ORDER DATA CUT-OFF: 90// 99999".
9 / RA*5*41: Deleted O - Orders only and A - All three.
9 / RA*5*41: Purging orders/requests was deleted.
March 2006 / 18 / RA*5*57: Added Key Variable RACCOUNT.
Glossary / RA*5*57: Added glossary entries for PFSS, PFSS Account Reference, and PFSS Department Code.
April 2006 / 52 / RA*5*67: Renamed Performance Indicator menu to Timeliness Reports. Added Outpatient Procedure Wait Time menu and report to Timeliness Reports menu. Renamed Performance Indicator reports to Verification Timeliness reports (menu options unchanged).
July 2006 / 42 / RA*5*64: Added scaling factor description to File #79.2.
51 / RA*5*64: Added five reports to [RA WKL] menu: Physician CPT Report by I-Type, and four Physician wRVU reports.
52 / RA*5*64: Added two Procedure wRVU reports to [RA SPECRPTS] menu.
Glossary / RA*5*64: Added glossary entries for RVU, wRVU.
February 2007 / 18 / RA*5*79: Added file to RA Global
40 / RA*5*79: Added new file - #73.2 Radiology CPT By Procedure Type.
Glossary / RA*5*79: Updated glossary entry for Procedure Type.
June 2007 / 32 / Updated sections to reflect current functionality. (These updates are not associated with any particular patch.)
35 / RA*5*81: Added file #79.7 to VA FileMan File Protection list.
44 / RA*5*81: Added file #79.7 to the detailed list of files.
September 2007 / 53 / RA*5*80: Added new option to RA HL7 MENU.
June 2008 / 63 / RA*5*84: Added four new protocols
July 2008 / 50 / RA*5*56: Added new option, Outside Report Entry/Edit.
55 / RA*5*56: Added a new option, Restore a Deleted Report.
71 / RA*5*56: Added a definition for the ‘Deleted’ status.
71 / RA*5*56: Added a definition for the ‘Electronically Filed’ status.
72 / RA*5*56: Added two new valid report statuses to the definition.
May 2009 / 1 / RA*5*78: Added a phrase to the description of the interface in the Introduction
30 / RA*5*78: Added the new mail group name and description, RAD HL7 MESSAGE
32 / RA*5*78 :Added information about querying the VistA Radiology application for results
67 / RA*5*78: Updated the screen capture of the DBIAs section
69 / RA*5*78: Changed UCI to development environment in the note regarding XINDEX
September 2013 2009 / 42 / RA*5*97: Added BI-RADS and AAA codes to DIAGNOSTIC CODES file (#78.3)
43 / RA*5*97: Added definition for Abdominal Aortic Aneurysm (AAA)
71 / RA*5*97: Added definition for Breast Imaging Reporting and Data System (BI-RADS™)
February 2010 / 14
14 / RA*5*99:
· Updated the section heading to reflect change in reporting periods; "Schedule Perf. Indic. Summary for Fifteenth of Month Following the Quarter End."
· Updated “RA PERFORMIN SCHEDULE” to run quarterly vs. monthly.
August 2011 / 12
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Glossary / Patch RA*5.0*47:
· Added a new option to turn on the site-specific accession number: Site Accession Number Set-up.
· Replaced the example with an updated version.
· Updated the names of the Rad/Nuc Med HL7 manuals.
· Added a new option to the IRM Menu [RA SITEMANAGER]:
Site Accession Number Set-up.
· Added four new protocols:
RA CANCEL 2.4
RA EXAMINED 2.4
RA REG 2.4
RA RPT 2.4
· Added Site Specific Accession Number (SSAN) to the Glossary.
November 2013 / 19
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36-37
52
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87 / RA*5*113
Definition of ^RAD global Radiation Absorbed Dose file (#70.3)
VA FileMan File Protection on Radiation Absorbed Dose file (#70.3)
Routine List included; shows core Radiology routines (compiled routines may differ from site to site)
Special Reports’ [RA SPECRPTS] Menu update: includes new ‘Radiation Dose Summary Report’ [RA RAD DOSE SUMMARY] menu item
‘Patient Profile Menu’ [RA PROFILES] includes new Exam Profile with Radiation Dosage Data [RA PROFRAD DOSE] menu item.
Software / Documentation Notes and Patch descriptions
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TOC
Table of Contents
1. Introduction 1
2. Implementation 2
Implementation of a Virgin Installation 2
Implementation of an Installation over V. 4.5 3
Informational Messages 3
3. Maintenance 4
Imaging Type Mismatch Report 4
IRM Menu 4
Device Specifications for Imaging Locations 4
Distribution Queue Purge 5
Failsoft Parameters 6
Imaging Type Activity Log 6
Purge Data Function 6
Output 7
Rebuild Distribution Queues 11
Report File x-ref Clean-up Utility 11
Site Accession Number Set-up 12
Credit completed exams for an Imaging Location 13
Resource Device Specifications for Division 14
Schedule Perf. Indic. Summary for Fifteenth of Month Following the Quarter End 14
Template Compilation 14
4. Globals 18
5. Key Variables 20
Function 29
Bulletins 29
Mail Groups 30
6. Security 31
Keys 31
RA ALLOC 31
RA MGR 31
RA VERIFY 31
Sign-on Security 31
Electronic Signature 32
VistA Options 32
COTS HL7 Interfaces 32
VA FileMan File Protection 34
Legal Requirements 35
7. Routine List 36
8. File List 38
Files 38
Templates 44
Input Templates 44
Sort Templates 46
Print Templates 47
List Templates 48
9. Exported Options 49
Exported Menus 49
IRM Menu [RA SITEMANAGER] 49
Rad/Nuc Med Total System Menu [RA OVERALL] 49
Rad/Nuc Med Clerk Menu [RA CLERKMENU] 57
Rad/Nuc Med Ward Clerk Menu [RA WARD] 58
Rad/Nuc Med File Room Clerk Menu [RA FILERM] 58
Interpreting Physician Menu [RA RADIOLOGIST] 58
Reports Menu [RA REPORTS] 59
Rad/Nuc Med Secretary Menu [RA SECRETARY] 60
Rad/Nuc Med Technologist Menu [RA TECHMENU] 61
Rad/Nuc Med Transcriptionist Menu [RA TRANSCRIPTIONIST] 61
Single Options 62
Menu/Option Assignment 62
Protocols 62
FileMan Options 64
10. Archiving and Purging 64
11. Callable Routines 64
12. External Relations 65
DBIAs 66
13. Internal Relations 67
14. Package-wide Variables 67
15. How to Generate On-line Documentation 68
Build File Print 68
Question Marks 68
XINDEX 69
Inquire to File Entries 69
Print Options File 69
List File Attributes 69
16. Glossary 71
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TOC
1. Introduction
The Radiology/Nuclear Medicine package is a comprehensive software package designed to assist with the functions related to processing patients for imaging examinations.
The package automates a range of Radiology/Nuclear Medicine functions, including order entry of requests for exams by clinical staff, registration of patients for exams, processing of exams, recording reports/results, verification of reports on-line, displaying/printing results for clinical staff, automatic tracking of requests/exams/reports, and generation of management statistics/reports, both recurring and ad hoc.
The package automates many tedious tasks providing faster, more efficient and accurate data entry and more timely results reporting.
The package interfaces with the Record Tracking package for the purpose of tracking Radiology/Nuclear Medicine records and creating pull lists for those records needed for scheduled clinic appointments.
· It interfaces with and through the Health Level Seven (HL7) package for the exchange of exam and report information with other VistA applications as well as Commercial Off The Shelf (COTS) applications.[1]
· It interfaces with the Health Summary package to allow users to see patient histories and test results which may influence the nature of the examination.
· It interfaces with the Computerized Patient Record System (CPRS) package to allow requesting of exams and viewing of reports.
· It interfaces with the Adverse Reaction Tracking (ART) package for the exchange of data concerning a patient's allergies.
· It interfaces with Patient Care Encounter (PCE) for crediting outpatient imaging procedures.
· It also interfaces with the AMIE package to display exam results.
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implementation
2. Implementation
Implementation of a Virgin Installation
Enter at least one division into the Rad/Nuc Med Division file #79 to activate the system. The division can be further defined by the ADPAC.
Give the ADPAC access to at least one Imaging Location (field #74) in the New Person file (#200). Without this, no one will be able to sign onto the system. Once the ADPAC has access, s/he must give each package user (technologist, interpreting resident physician, interpreting staff physician, or clerk) location access so they can sign on. The ADPAC can give users access with the Classification Enter/Edit [RA PNLCLASS] option. Without an assigned imaging location, a user simply cannot access the package.
Along with the ADPAC, determine the devices needed for each Imaging Location that will be defined. Use the option Device Specifications for Imaging Locations [RA DEVICE] in the IRM Menu [RA SITEMANAGER] to assign them.
Associate an existing or new mail group with each of the exported bulletins (see page 29) so users can receive these Radiology/Nuclear Medicine messages. The bulletins are generated when an important action has taken place, such as the deletion of a report. Consult with the package ADPAC to determine how many mail groups to create, what mail group(s) to associate with each bulletin and who should be the mail group coordinator. It is strongly recommended that a mail group with the ADPAC and possibly an IRM support person as recipients be established and associated with the RAD/NUC MED CREDIT FAILURE bulletin. This is the only way users can be notified of credit failure due to lack of data or wrong data in Radiology/Nuclear Medicine.
Verifying reports [2]
VistA reports: Give the RA VERIFY key to staff that will be verifying reports and make sure they have an electronic signature.
COTS Voice Recognition Systems: In addition to the above, assign verifying privileges to staff that will be verifying reports on a COTS Voice Recognition system. Also, assign an ID to each physician that matches his/her IEN in the New Person file #200.
The IRM Menu [RA SITEMANAGER] and the standalone option Imaging Type Mismatch Report [RA EXAM/STATUS ITYPE] covered in this chapter will help with the continued maintenance of the software. Further implementation and maintenance can be done by the ADPAC and is described in full in the Radiology/Nuclear Medicine ADPAC Guide.
Implementation of an Installation over V. 4.5
- Verifying reports [3]
VistA reports: Give the RA VERIFY key to staff that will be verifying reports and make sure they have an electronic signature.
COTS Voice Recognition Systems: In addition to the above, assign verifying privileges to staff that will be verifying reports on a COTS Voice Recognition system. Also, assign an ID to each physician that matches his/her IEN in the New Person file #200. - The burden of Implementation falls mainly on the ADPAC and is fully discussed in the ADPAC Guide with a checklist of steps to use in the implementation process.
Informational Messages
There are two main messages that users may receive that concern IRM particularly during implementation after a virgin installation:
- Radiology/Nuclear Medicine Division definition error. Call your site manager.
When a user calls about this message, it means there is insufficient information in the imaging location that was selected by the user. Make sure the ADPAC has assigned that location to a division in the Division Parameter Set-up option Rad/Nuc Med Division file (#79), field #50.
- No default "ABC" printer has been assigned. Contact IRM.
This message appears when the ADPAC is editing an imaging location in the Location Parameter Set-up option and as yet, a printer has not been assigned for that activity (jacket labels, flash cards, or exam labels). Use the option Device Specifications for Imaging Locations [RA DEVICE] to assign them.
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